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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Coronary atheroma develop in local sites that are widely variable among patients and are considerably variable in their vulnerability for rupture. This article summarizes studies conducted by our collaborative laboratories on predictive biomechanical modeling of coronary plaques. It aims to give insights into the role of biomechanics in the development and localization of atherosclerosis, the morphologic features that determine vulnerable plaque stability, and emerging in vivo imaging techniques that may detect and characterize vulnerable plaque. Composite biomechanical and hemodynamic factors that influence the actual site of development of plaques have been studied. Plaque vulnerability, in vivo, is more challenging to assess. Important steps have been made in defining the biomechanical factors that are predictive of plaque rupture and the likelihood of this occurring if characteristic features are known. A critical key in defining plaque vulnerability is the accurate quantification of both the morphology and the mechanical properties of the diseased arteries. Recently, an early IVUS based palpography technique developed to assess local strain, elasticity and mechanical instabilities has been successfully revisited and improved to account for complex plaque geometries. This is based on an initial best estimation of the plaque components' contours, allowing subsequent iteration for elastic modulus assessment as a basis for plaque stability determination. The improved method has also been preliminarily evaluated in patients with successful histologic correlation. Further clinical evaluation and refinement are on the horizon.
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PMID:Biomechanics of atherosclerotic coronary plaque: site, stability and in vivo elasticity modeling. 2404 5

Introduction: Coronary atheroma progression correlates with adverse cardiovascular events among individuals with coronary artery disease. Atherosclerosis imaging, including coronary intravascular ultrasound (IVUS), has provided novel insights into the biologic contributors to atheroma progression or regression, improving the efficiency of drug development by identifying therapies most likely to succeed in clinical outcomes trials. Areas covered: Despite widespread use of statins, residual risk for adverse events is high among individuals with cardiovascular disease receiving optimal medical therapy. This review outlines current studies, including patient-level analyses of large randomized clinical trials, demonstrating several factors that associate with coronary plaque progression in the context of statin therapies. Expert opinion: Atherosclerotic plaque remains a fundamental substrate underlying the occurrence of ischemic events in the current era of cardiovascular care. Understanding pathobiologic contributors to atherosclerosis, targeting treatment pathways, generating high-quality data, and implementing evidence into clinical practice are necessary to improve outcomes among patients with atherosclerotic disease.
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PMID:Coronary atherosclerotic plaque progression: contributing factors in statin-treated patients. 3304 22